First Bottle

We bottle-fed the twins yesterday. That was the first time they ate from a bottle; prior to that all of their sustenance came intravenously or through a Gavage feeding,* which is a tube running through the nose carrying milk directly to the stomach.

We were surprised when the nurse asked if we wanted to bottle-feed yesterday. We had entered the NICU planning to simply hold them for their hour-long break from the bile lights** when the nurse popped the question. The nurse actually asked if we wanted to feed them for the first time, as if there was a chance we might say “Nah, we’ll do enough of that when we take them home” or “I’d love to, but ‘Days’ starts in 20 minutes.”

Being an experienced dad, I thought I knew all about feeding newborns. I simply shove a bottle in his mouth, stuff him full of milk, wipe up the spit-up, burp him, wipe up more spit-up, and hand him off to mommy so I can take a nap. Fortunately the nurse gave us detailed instructions on how to feed preemies before handing me the bottle. I had to take special precautions to protect a preemie’s fragile frame.

First, feed him on his side. That way if milk pools in his mouth it pools to the side, not in the back of the mouth where it could create a choking hazard because a preemie when a preemie chokes on food he often buys a few more days at Club NICU. Second, watch his breathing. Preemies are already prone to forgetting to breathe, plus their suck-swallow-breathe-repeat reflex often hasn’t developed yet. If the little guy focuses on the suck-swallow part at the expense of the breathe part for too long, tip the bottle down so the milk flows out of the nipple and he remembers that, fun as it may be to eat, his primary job is still to breathe.

The nurse handed us bottles festooned with the Enfamil*** logo. The last time I bottle-fed Abbie, she was sucking down nine-ounce bottles over-stuffed with milk. These were two-ounce bottles filled with 10ccs**** of milk. Right now Abbie has more milk than that left in her sippy cups when she throws them on the floor.

I fed Tory; Ellie fed Ian. At first I was a little jealous of Ellie because Ian was sucking much better than Tory. I should have remembered that Tory has consistently been a little behind his brother, so Ian would likely be a better sucker. Then I realized that just meant there was more work for me to do with him. After much cajoling with every feeding trick I could remember from Abbie, Tory ripped off a few good sucks for a first-timer.

When all the sucking was done, Tory consumed 4ccs, and Ian took 3ccs. It’s important that I not from this as a competition between them, so let’s just say I was pushing him harder than Ellie. Afterwards we set them back in their isolettes to finish their milk through Gavage feeding.***** Then we said goodbye and left the hospital because their daily holding limit had been reached. Plus “Jeopardy” was on in ten minutes.

* Gavage feeding is named for its innovator, Dr. Bob “Dodge” Gavage.
** Their bile is dropping, and they might be off the bile lights for good tomorrow. Or they may stay on the lights for another day or two. Or they may go off the lights and go right back under again in a couple days. I’m learning not to expect much daily progress.
*** Motto: “Breastmilk is best … but Enfamil is so much easier!”
**** 30ccs = 1oz. 24ozs = The average daily intake for a newborn. 8393.36oz = 1 hogshead.
***** They’re up to 25ccs total every three hours.